Elderberry

Traditionally, Indigenous people used it to treat fever and rheumatism, while the ancient Egyptians used it to improve their complexions and heal burns.

Elderberry is a dark purple berry that grows on the Sambucus nigra plant, also known as the European or black elder tree. It is a rich source of antioxidants known as anthocyanins and is often used to support the immune system.

The ripe berry is tart and typically sweetened, similar to cranberries. One cup of elderberries provides 106 calories, 27 grams (g) of carbohydrates, 10 g of fiber, 52 milligrams (mg) of vitamin C, 2.3 mg of iron, and 406 mg of potassium.

Elderberry is not the same as American Elder, Elderflower, or Dwarf Elder, and these will not provide the same intended benefit as elderberry.

Elderberry is often touted for use against viral infections such as the common cold or the flu. It is marketed for several other conditions as well, but research is lacking.

Benefits

There are many reported benefits of elderberries. Not only are they nutritious, but they may also help address cold and flu symptoms, support heart health, and fight inflammation and infections, among other benefits.

• High In Nutrients such as fiber, vitamin C, iron, and potassium
• Source of antioxidants, which may promote health by reducing cell damage caused by free radicals
• Provides cold and flu relief
• Lowers Blood Sugar
• Reduces Sinus Infection Symptoms
• Natural Laxative
• Supports skin health
• May improve heart health
• Has cancer-fighting qualities

Elderberry contains a whole host of immune-boosting antioxidants, including vitamins A, B, and C. These antioxidants and vitamins can help keep your immune system strong and allow you to better fight off infections, such as common viruses like the cold or flu.

For example, a 2016 study found that 300mg elderberry supplement capsules, taken twice per day, a few days before and after long-haul flights significantly reduced the duration and severity of cold symptoms for travelers.

Another 2020 review of five elderberry studies concluded that, when taken within 48 hours of initial symptoms, elderberry supplements may reduce the length and severity of fever, headache, runny nose, and congestion associated with cold and flu.

Elderberry also contains anthocyanins — a pigment with antioxidant effects that give berries their red, blue, purple, or black coloring. Anthocyanins are thought to prevent flu viruses from reproducing inside our bodies, which may prevent the onset of flu or decrease the duration of its symptoms.

In fact, laboratory tests have shown that anthocyanins can inhibit neuraminidase, which is "a part of a virus that allows for budding, and thus replication, of a virus," says Thomas Holland, MD, a physician-scientist in the departments of internal medicine and clinical nutrition at Rush Medical College in Chicago.

For example, the flu-busting antiviral oseltamivir, known by the brand name Tamiflu, is also a neuraminidase inhibitor and works to reduce flu symptoms by the same mechanism.

Holland says elderberry contains a variety of "bioactives" — anti-inflammatory compounds you might've heard of like tannins and flavonoids that can help prevent damage to our bodies' cells.

Stress, polluted air, unhealthy foods, and substances like alcohol or tobacco can all cause inflammation in the body, which may contribute to cellular damage, Holland says. That cellular damage can in turn generate free radicals — harmful byproducts of the body that can lead to chronic diseases like heart disease, Alzheimer's, and cancer.

"Taking foods, especially berries, that have these antioxidant, anti-inflammatory properties can prevent that onset of cellular damage, or decrease the inflammation that's happening," Holland says.

Elderberries are rich in bioactive flavonoids, which multiple studies have suggested help lower blood pressure and prevent the onset or progression of heart disease.

In a small 2017 study, adults 50 to 70 years old who were given a bioactive-rich mixed berry drink (including elderberries) daily for five weeks saw a significant decrease in cholesterol levels overall and LDL cholesterol in particular compared to those given a placebo.

Risks, Side Effects and Interactions

Despite the many health benefits associated with this medicinal plant, there are several elderberry side effects to consider as well.

Ripe, cooked berries from most of the Sambucus species are edible. However, you should not consume raw berries or other parts of the plant since they contain a cyanide-inducing chemical, which can result in nausea, vomiting or diarrhea.

Generally, commercial preparations don’t cause adverse reactions when used at recommended dosages.

Elderberry appears to have few side effects when used properly for short periods of time of up to five days. Occasionally, however, elderflowers and elderberries can cause allergic reactions.

Discontinue use if you have a mild allergic reaction, and seek medical attention if you have a serious allergic reaction.

Using elderberry supplements for kids is not recommended unless you’ve consulted with your pediatrician. If you’re pregnant or breastfeeding, don’t take this herb, as research is lacking on its effects on fetal health and development.

If you have an autoimmune disease, such as rheumatoid arthritis, ask your doctor before taking elderberry supplements because it may stimulate the immune system. If you have any other ongoing health concerns, talk with your health care provider before taking it as well. People with organ transplants should not take elderberry.

Because of its powerful effects on health, elderberry supplements could potentially interact with several medications. If you currently take any of the following medications, you should talk to your health care provider before using an elderberry supplement or any other elder plant products:

• Diabetes medications
• Diuretics (water pills)
• Chemotherapy
• Immunosuppressants, including corticosteroids (prednisone), and medications used to treat autoimmune diseases
• Laxatives
• Theophylline (TheoDur)

Dosage: How Much Elderberry Should I Take?

There is no standard recommendation for dosing elderberry.

In some clinical trials, adults took 3 teaspoons (1 tablespoon) of elderberry extract in syrup form four times daily for five days. Since there is no standard dosage, however, consult your healthcare provider or pharmacist and read the dosage directions on the product label before taking it.9

There are no standard recommended amounts for elderberry in gummies, tablets, or teas.

What Happens If I Take Too Much Elderberry?

Elderberry extract appears to be safe when taken in small doses. Taking amounts greater than recommended could be more likely to result in undesirable side effects.

Elderberries should always be cooked and processed before they’re consumed. Unripened, raw elderberries can release toxins into your body. Even ripe berries can contain trace amounts of cyanide, so you must cook elderberries before consumption.

Poisoning from elderberries is rarely life-threatening. But it may cause:11

• Nausea
• Vomiting
• Abdominal cramps
• Weakness
• Dizziness

Get medical attention if you develop these symptoms after consuming elderberry.

Conclusion

While elderberry has been associated with many promising health benefits, most of the research has only been conducted in a lab setting and not tested extensively in humans.

Therefore, elderberry cannot be recommended for any particular health benefit.

Reasonable evidence supports its use to help reduce the length and severity of flu symptoms.

Also, it may support heart health, improve antioxidant status, and have a variety of anti-cancer, anti-diabetes, and anti-inflammatory effects.

Moreover, elderberry is a flavorful addition to a healthy diet and a good source of vitamin C, fiber, and antioxidants.